Screening for precancerous anal lesions linked to human papillomaviruses: French recommendations for clinical practice.

In France, about 2000 new cases of anal cancer are diagnosed annually. Squamous cell carcinoma is the most common histological type, mostly occurring secondary to persistent HPV16 infection. Invasive cancer is preceded by precancerous lesions.

How to manage anal ulcerations and anorectal stenosis in Crohn's disease: algorithm-based decision making : French National Working Group Consensus 2018.

The French National Society of Coloproctology established national recommendations for the treatment of anoperineal lesions associated with Crohn's disease. Treatment strategies for anal ulcerations and anorectal stenosis are suggested. Recommendations have been graded following international recommendations, and when absent professional agreement was established.

Online training on how to diagnose anoperineal lesions of Crohn's disease: Do pictures matter? A nationwide randomized study.

Unlabelled: Any gastroenterologist must be trained to properly diagnose anoperineal lesions in patients with Crohn's disease (APLOC). The aim of this study was to establish whether adding pictures would improve teaching effectiveness of the diagnosis of APLOC to French gastroenterology trainees.

Method: Trainees were asked to answer a first web-based survey consisting of evaluating 12 pictures of APLOC with a closed answer questionnaire.

Management of anoperineal lesions in Crohn's disease: a French National Society of Coloproctology national consensus.

The French National Society of Coloproctology established national recommendations for the treatment of anoperineal lesions associated with Crohn's disease. Treatment strategies for acute abscesses, active fistulas (active denovo and still active under treatment), fistulas in remission, and rectovaginal fistulas are suggested. Recommendations have been graded following the international recommendations, and when absent, professional agreement has been established.

Anoperineal lesions in Crohn's disease: French recommendations for clinical practice.

Background: Anoperineal lesion (APL) occurrence is a significant event in the evolution of Crohn's disease (CD). Management should involve a multidisciplinary approach combining the knowledge of the gastroenterologist, the colorectal surgeon and the radiologist who have appropriate experience in this area. Given the low level of evidence of available medical and surgical strategies, the aim of this work was to establish a French expert consensus on management of anal Crohn's disease.

Elaboration and validation of Crohn's disease anoperineal lesions consensual definitions.

Aim: To establish consensual definitions of anoperineal lesions of Crohn's (APLOC) disease and assess interobserver agreement on their diagnosis between experts.

Methods: A database of digitally recorded pictures of APLOC was examined by a coordinating group who selected two series of 20 pictures illustrating the various aspects of APLOC. A reading group comprised: eight experts from the Société Nationale Française de Colo Proctologie group of study and research in proctology and one academic dermatologist.

Guidelines for the treatment of hemorrhoids (short report).

Hemorrhoids are a common medical problem that is often considered as benign. The French Society of Colo-Proctology (Société nationale française de colo-proctologie [SNFCP]) recently revised its recommendations for the management of hemorrhoids (last issued in 2001), based on the literature and consensual expert opinion. We present a short report of these recommendations.

The outcome of fistulotomy for anal fistula at 1 year: a prospective multicentre French study.

Aim: The study aimed to evaluate outcome at 1 year of one- and two-stage fistulotomy for anal fistula in a large group of patients.

Method: A prospective multicentre observational study was designed to include patients with anal fistula treated by one- or two-stage fistulotomy. Data were collected using a self-administered questionnaire before surgery, during healing and at 1 year after surgery.

The results of seton drainage combined with anti-TNFα therapy for anal fistula in Crohn's disease.

Aim: Combined infliximab and sphincter-sparing surgery can be effective in perianal fistula associated with Crohn's disease (CD). This study aimed to assess the efficacy of local surgery combined with infliximab on sustained fistula closure and to identify predictive factors for response after this combined treatment.

Method: Between 2000 and 2010, 81 patients with fistulising perianal CD were included in this observational study.

Efficacy of a CO2-releasing suppository in dyschezia: a double-blind, randomized, placebo-controlled clinical trial.

Background: Constipation has a significant impact on quality of life. Aim of this study was to evaluate the safety and the efficacy for relieving dyschezia symptoms of a CO2-releasing suppository in a randomized, placebo-controlled, clinical trial.

Methods: Fifty-three office-based primary care physicians and 24 gastroenterologists conducted the study in France, between November 2010 and January 2012.

One-year outcome of haemorrhoidectomy: a prospective multicentre French study.

Aim: An evaluation was performed of the 1-year outcome of open haemorrhoidectomy (Milligan and Morgan alone or with posterior mucosal anoplasty [the Leopold Bellan procedure]).

Method: A prospective, multicentre, observational study included all patients having a planned haemorrhoidectomy from January 2007 to June 2008. Data were collected before surgery, and at 3 months and 1 year after surgery.

Sphincter-sparing anal-fissure surgery: a 1-year prospective, observational, multicentre study of fissurectomy with anoplasty.

Aim: Internal sphincterotomy is the standard surgical treatment for chronic anal fissure, but is frequently complicated by anal incontinence. Fissurectomy is proposed as an alternative technique to avoid sphincter injury. We describe 1-year outcomes of fissurectomy.

[Outpatient treatments of haemorrhoidal disease].

Only three non-surgical treatments of haemorrhoids are clearly validated: infrared coagulation, injection sclerotherapy and rubber band ligation. Those procedures are only indicated for painless symptoms related to internal haemorrhoids, i.e.

[Epidermoid anal carcinoma].

Epidermoid carcinoma of the anus is a rare cancer, and conventionally affects elderly women. Its incidence is on the increase, at a younger age of onset, particularly within the male homosexual population. Main predisposing factors are sexually transmitted diseases and particularly human papillomavirus (HPV) infection, variety of sexual partners, smoking, homosexuality, history of uterine cervix cancer, and immunodepression.

Ano-rectal complaints in general practitioner visits: consumer point of view.

Aims: The perception patients consulting for primary care have of anorectal disorders has never been evaluated. Our aim was to analyze proctological complaints among outpatients consulting general practitioners.

Patients And Methods: Among 1484 physicians who responded to a nationwide mailing in France, 161 enrolled 437 females and 358 males consulting between October 2004 and December 2005.

[Chronic perineal pain].

Chronic perineal pain, too easily considered in the past as psychogenic, has undergone significant reshapings in recent years because of a better understanding of pathophysiology. Progress in functional investigations, especially electrophysiological tests, has allowed to define new clinical entities such as pudendal neuralgia or pain linked to pelvic floor disorders. Treatments have been improved, but remain empirical outside these well defined entities.

Intracolonic injection of glycerol: a model for abdominal pain in irritable bowel syndrome?

Background & Aims: Abdominal pain is the main symptom in patients with irritable bowel syndrome (IBS). Glycerol is an irritant of colonic mucosa. The aim of this study was to evaluate the effects of an intraluminal injection of glycerol on colonic motility and tone in patients with IBS and their modulation by drugs.

[Specific respiratory manifestations associated with hemorrhagic rectocolitis. Analysis of a case and review of the literature].

Respiratory impairments occurring as systemic manifestations of ulcerative colitis are often misinterpreted. We report a case of chronic productive bronchitis associated with ulcerative colitis; symptoms appeared after colectomy. Clinical features distinguished it from common chronic bronchitis: it occurred in a woman without respiratory disease or smoking history, a chronic productive cough without bronchiectasis, negative infectious investigations, severe endoscopic and histologic lesions, and above all remarkable steroid efficacy.